Thursday, May 27, 2010

Groundhog Day With Students

This morning I rose at ten to five (TEN TO FIVE, I TELL YOU!) to travel to a Far City, where some first-year student doctors were having their examination, or OSCE - Objective Structured Clinical Examination.

I was being a Simulated Patient, playing someone who had recently had an operation (and working from a detailed brief with lots of information about it). Because they were first years with very little medical knowledge, their task was to discuss the operation and my feelings about it with me.

This isn't easy: there are many different things that they learn to do in Communication Skills, of which the most basic is introducing themselves properly, checking my name and finding out what I'd like to be called - Mrs Jenkins or Helen, for example. They have to explain that the conversation will be confidential - - and what that actually means: in the case of a student doctor it might mean that someone else might need to be told, such as the doctor or nurse involved with the patient.

Then they had to talk to the patient sensitively and with empathy, and build up a rapport, and find out as much as possible.

To do all this, they had six minutes each in total.

This may not seem very long, but actually if you have good communication skills you can get a long way in six minutes.

In the later years of their course the OSCE stations are longer - - but usually only eight minutes in total, which, if you think about it, is about the length of a consultation with a GP.

As a matter of fact, almost all of today's students had been taught well, and had learned well. There were a few sentences that were a bit clunkily worded ("How would you like me to address you?") but far more good than bad wording, and many of the students were excellent.

And there were a lot of them. OSCEs are always like that, for the Simulated Patient.

We had to arrive at eight because there are so many students that there are several Simulated Patients playing the same role, and hence we need to standardise all the details of how we play it, so it's fair. Exactly how much do we drink? When exactly did we give up smoking?

Starting at nine o'clock, there were sixteen students one after the other, then a ten-minute coffee break, then another sixteen students, then lunch, then thirteen students, then tea, and then another thirteen students, finishing at about ten past five.

So today I have discussed my (fictitious) operation with fifty-eight students. It takes a lot of concentration to keep it fresh, so that you give every student the same opportunity. My secret is caffeine: Red Bull in the afternoons! I don't drink it at any other time but for OSCEs it's brilliant.

It's been a long day and now I'm home I'll be going to bed soon, even though it's only half-past eight. But it's interesting, rewarding work and I love it.